The Community Child Health Network (CCHN) Phase II research proposes to: (1) advance understanding of the combined biomedical, social, behavioral, and environmental influences on the course of prenatal development, pregnancy outcome, and early child development, particularly in physical growth, respiratory function, and language development. CCHN proposes a 5-site, longitudinal study of 2 integrated cohorts: a Birth Cohort Study of 5250 families (1050 per site) followed by a Subsequent Birth Study (38 percent of mothers expected to have a subsequent live birth). These studies focus on the role of stress and allostatic load, as moderated by resilience and supports, on pregnancy outcome, fetal programming, and child development outcomes of prematurity/intrauterine growth restriction, overweight, asthma, and language and cognitive development; and (2) to develop and document active community participation in all phases of the study through the community based participatory research (CBPR) in the community-academic partnerships (CAPs). The findings are intended to advance theory about the etiology and impact of health disparities related to pregnancy and early childhood outcomes, as well as inform the design of future preventive interventions. Innovative features include: 1) focus on the inter- and pre-conception period; 2) combining biomedical and psychosocial indicators and outcomes within an integrated conceptual framework; 3) multidisciplinary measures of resilience and supports as well as risks; 4) including fathers as integral to both pregnancy and child health outcomes; and 5) a participatory research partnership of the community and university at local sites and the national network. North Carolina persists in having maternal and child health disparities in preterm birth, infant mortality, and access to health care. These poor birth outcomes disproportionately affect families in the predominately rural Eastern part of the state. Partnered together in this community based, multilevel research project will be the UNC Center for Women's Health, the UNC Cecil G. Sheps Center for Health Services Research, East Carolina University School of Medicine and School of Health and Human Performance, as well as the Eastern North Carolina Baby Love Plus Project. Eastern NC community partners have participated fully in the research planning and will have crucial roles to play in the initiation, conduct, and analyses, of this cohort study [unreadable] [unreadable] [unreadable]